Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1983, 09-09 Permit: 83A-8868 MH
ro PLAN NUMBER APPLICATION/PERMIT SPOKANE COUNTY - DEPARTME(► OF BUILDING & SAFETY NORTH 811 JEFFERSON / SPOKANE, WASHINGTON 99260 / (509) 456-3875 APPLICANT: COMPLETE NUMBERED SPACES — PRESS HARD TO MAKE 3 COPIES 1. 2. STREET ADDRESS 5, II7 -O LOT BLOCK PARCEL NO. 9.1 44 ` 9 SUBDIVISION OWNER 3 bOr,IS M -�I. MAILING ADDRESS 11707 [off CONTRACTQR„ ADDRESS 4. PHONE PHONE ZIP tC7 LErIAL DESCRIPTIO'Ni i ,k1. poi o 6 • ' G� 12"/ W�-. 010-1.11.74..or N1L4y.. Actual Set Backs in Feet to: North '3 0 'South East I West LICENSE EXPIRES PHONE ZIP DESIGNER PHONE 5. ADDRESS 6. CHANGE OF USE FROM TYPE 7. OF WORK DESCR VALUATION 9. ip a 8. NEW 0 BLD. ZIP ❑ ALT. 0 AD' N. 0 IPL. ❑ MVE. ❑ PLMB. 0 MECH. 7'M.H. 0 POOL O BE WOI � IRK r 64- 7o x 1 �� J1 SOURCE GAS ELECTRIC UTILITIES 0 OTHER Size of Parcel D4e4lassification j©O>c I ►4,I� Typl zit. Oppancy Reeidential�X Commercial 0 Sprinklered ❑Yes ❑No ❑Req'd. New Const. Valuation Main Floor Cover Deck Remode ed Valuation Total Bldg. Floor Area Upper Floors Garage/Storage Greenhouse Uncv. Deck Fin. Basement Unfin. Basement No. Baths No. Floors No. Fin. Rooms No. Dwellings Certifi. of Exempt. or Variance Required YesNo❑ Received Yes Noll c 5z - Shorelines/ Flood Hazard Yes NotApplic. 0 WATER PUBLIC PRIVATE 0 SEWAGE/ SEPTIC l8' SEWER 0 Ownership Public 0 Private I hereby certify that I have read and examined this appl cation and have read the "NOTICE" provisions included on reverse side, and know the same to be true and correct. Alt provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give au- thority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. SEE REVERSE SIDE FOR REQUIRED INSPECTIONS SIGNATURE OF D� OWNER OR AGENT lt4 / SPECIAL APPROVALS SPECIAL CONDITIONS: (SEE REVERSE SIDE FOR NOTICE) PRELIM. FINAL DATE DATE CATION 3 %q' g� Plans Required 0 Received 0 ill I Env. Health Planning Fire Prevent. Engineer Utilities SEPA Plans Exam. Building Tech. q(6 PERMIT IS NONTRANSFERABLE PERMIT IS NULL AND VOID IF WORK HAS NOT COMMENCED IN 180 DAYS FEES COLLECTED Building Plumbing Mech. Plan Check SEPA Modular/ MFG. Home Other (Specify) TOTAL $ 50 PERMIT NUMBER 07* *5000 *50006 A *000 15382 03-04-83 2 6479. WHEN MACHINE VALIDATED IN THIS SPACE, THIS BECOMES A PERMIT. DATE ISSUEDO 9 - 8 PERMIT IVO: 6. 8 z *50.00 AL 1.5' 0 0) 00 X J